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Canadian Journal of Cardiology

Childhood Obesity and Cardiovascular Disease Risk: Working Toward Solutions

  • Patrick G. McPhee
    Affiliations
    Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada

    Centre for Metabolism, Obesity, and Diabetes Research, McMaster University, Hamilton, Ontario, Canada
    Search for articles by this author
  • Selena Singh
    Affiliations
    Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada

    Centre for Metabolism, Obesity, and Diabetes Research, McMaster University, Hamilton, Ontario, Canada
    Search for articles by this author
  • Katherine M. Morrison
    Correspondence
    Corresponding author: Dr Katherine M. Morrison, HSC 3A59, 1280 Main St W, Hamilton, Ontario L8N 3Z5, Canada. Tel.: +1-905-521-2100 ext 75926; fax: +1-905-308-7548.
    Affiliations
    Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada

    Centre for Metabolism, Obesity, and Diabetes Research, McMaster University, Hamilton, Ontario, Canada
    Search for articles by this author

      Abstract

      The prevalence of obesity in childhood is high and continues to increase globally. It is currently estimated that 381 million children worldwide have overweight or obesity. This disease stems from multiple complex pathways that can present early in life. This is particularly concerning because childhood obesity is associated with cardiovascular risk factors that can lead to early atherosclerosis and premature cardiovascular disease (CVD). Hypertension, dysglycemia, dyslipidemia, and systemic inflammation are associated with vascular changes in childhood, and these contribute to increased risk of cardiovascular events in adulthood if not adequately treated. Interventions to treat childhood obesity include multicomponent family-based behaviour modification programs, which have been demonstrated to have moderate short-term effects on weight-related outcomes; their effects on cardiovascular risk factors, however, are less well understood. Although supervised, structured exercise interventions result in improvements in blood pressure, inflammation, carotid artery intima media thickness, dysglycemia, dyslipidemia, and endothelial dysfunction in children with obesity in the short term, our understanding of how to translate these interventions into long-term sustainable exercise or physical activity recommendations remains uncertain. Research focus in these areas will help in treating childhood obesity and associated CVD risk factors to prevent CVD development in adulthood.

      Résumé

      L’obésité juvénile est un problème très prévalent qui ne cesse d’augmenter à l’échelle mondiale. Selon les estimations, quelque 381 millions d’enfants dans le monde souffriraient d’embonpoint ou d’obésité. Cette maladie résulte de plusieurs parcours complexes, qui peuvent s’amorcer très tôt au cours de la vie. Il s’agit d’un phénomène particulièrement préoccupant, l’obésité juvénile étant associée à des facteurs de risque cardiovasculaire pouvant entraîner une athérosclérose précoce et l’apparition prématurée de maladies cardiovasculaires (MCV). L’hypertension, la dysglycémie, la dyslipidémie et l’inflammation générale sont toutes associées à des changements vasculaires survenant durant l’enfance qui, s’ils ne sont pas pris en charge comme il se doit, augmentent le risque de manifestations cardiovasculaires à l’âge adulte. Les interventions visant à traiter l’obésité juvénile comprennent des programmes de modification des habitudes de vie à plusieurs volets s’adressant aux familles, qui se sont révélés avoir des effets à court terme modérés sur les issues liées au poids; leur incidence sur les facteurs de risque cardiovasculaire est toutefois moins bien comprise. Même si des programmes d’activité physique structurés et supervisés ont à court terme des effets bénéfiques sur la pression artérielle, l’inflammation, l’épaisseur de l’intima média carotidienne, la dysglycémie, la dyslipidémie et la dysfonction endothéliale chez les enfants obèses, on ne comprend pas encore bien comment transposer ces interventions en recommandations en matière d’activité physique applicables à long terme. Des recherches plus poussées sur ces questions aideront à traiter l’obésité juvénile et les facteurs de risque de MCV qui y sont associés, afin de prévenir l’apparition de MCV à l’âge adulte.
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